I use daily the ANI monitor during my opioid-free anesthesia to titrate the non-opioid analgesic drugs. It allows me to reduce the dexmedetomidine and lidocaine dosages, which results in a faster and better awakening process of the patient as hemodynamics do not always reflect the surgical stress of the patient.

ANI offers the clinician the possibility to control vagal and parasympathetic activity in the operating room, critical care and perioperative setting in general. This is an important feature that we’ll be significantly more important in the future.

At the heart of Enhanced Recovery After Surgery (ERAS) programs is the reduction in surgical stress. Whilst there are many approaches to this (such as minimally invasive surgery) a key area is excellent pain control. The ANI monitor allows objective intraoperative assessment of analgesia, permitting titrated pain control, optimizing patient analgesia and comfort and thus minimizing the stress response.

Inadequate analgesia is associated with increases in the number of intraoperative and postoperative complications. However, nociception monitoring is currently not part of standard clinical care in anesthesia. ANI could be a useful tool to titrate medication to specific surgical stimulation allowing for a personalized use of analgesics during surgery.

The objective measurement of pain is a much sought-after goal. Dr. Mathieu Jeanne proposed such a method 10 years ago, and this lead to the development of ANI. Looking at the autonomic nervous system responses with an emphasis on the parasympathetic. ANI guided analgesic delivery by reducing under or overdosing, thereby impacting patient outcomes in the operating room and ICU.

The monitoring of the heart rate variability according to a fixed respiratory rate in an anesthetized or sedated patient under controlled positive pressure ventilation is an important noninvasive pharmacodynamic parameter allowing the anesthetist or the intensivist to reduce remifentanil TCI or the opioid delivery.

Guiding and titrating the hypnotic and antinociceptive components of propofol dexmedetomidine based on general anesthesia with spectral analysis of EEG (Masimo root monitor) and ANI: A modern way to go.

Do we feel pain under anesthesia? Traditional heart rate, blood pressure response and depth of anesthesia monitoring don’t tell the whole picture of the body’s response to surgical stress. Trying out MDoloris Medical Systems today for the first time. All I can say is it’s a game changer. Now I can see real-time responses. No more guessing

The best biological signals to do amazing anesthesia. Security is the priority! Multimodal anesthesia technique with physiological control.